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Observation of movements during sleep in ALTE (apparent life threatening event) and apnoeic infants--a pilot study
C Einspieler1, H F Prechtl, L van Eykern
1Department of Physiology, Karl-Franzens-University of Graz, Austria.
Insights
Infants experiencing apparent life-threatening events (ALTE) showed reduced movement by 6 months. Abnormal sleep movements in ALTE and apnea infants suggest impaired neural function following these events.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Sleep medicine
Background:
- Apparent life-threatening events (ALTE) and prolonged sleep apnea in infants can impact neurodevelopment.
- Understanding motor development in infants with a history of ALTE or apnea is crucial for early intervention.
Observation:
- Video polysomnography recorded movements in 14 infants (2-6 months): 4 controls, 5 with ALTE history, 5 with recurrent apnea.
- Infants with ALTE showed normal movement quantity at 2 months but significantly reduced quantity at 6 months.
- Abnormal quality of spontaneous sleep movements was observed in most ALTE and apnea infants, consistent with previous wakefulness observations.
Findings:
- Motor activity in infants with ALTE was quantitatively similar to controls at 2 months but markedly reduced by 6 months.
- Infants with recurrent apnea did not exhibit significant changes in movement quantity.
- The quality of spontaneous movements during sleep was abnormal in nearly all infants with ALTE or apnea, regardless of age.
Implications:
- Reduced and abnormal motor function in infants following ALTE or apnea may indicate sequelae impacting neural functions.
- Early identification of abnormal motility could aid in assessing neurodevelopmental outcomes in at-risk infants.
- Further research is warranted to explore the link between sleep events, motor development, and neural function in infants.
Abstract:
Fourteen infants of 2 months or 6 months of age were video-recorded during polysomnography. Four were normal infants, five had a history of ALTE (apparent life threatening event) and five had repeated and prolonged apnoea during sleep. Two ALTE infants have been recorded at 2 months as well as at 6 months of age. Movements during sleep could be classified into general movements, isolated movements of the upper extremity, startles, head rotations, and trunk rotations. In the ALTE cases at 2 months of age, the motility was quantitatively not different from the control infants but was markedly reduced at 6 months of age. (All cases had their event before 8 weeks of age.) In contrast to these findings, infants with repeated apnoea did not show a clear change in the quantity of their movements. With the exception of one ALTE case at 2 months, all observed cases of ALTE and apnoeic infants showed an abnormal quality of their spontaneous movements during sleep. As reported in a previous study, all these cases had also been found moving abnormally during wakefulness. It is suggested that the abnormal motility is a sequelae of the event (ALTE or repeated apnoeas) with as a consequence, an impairment of neural functions.